Department of Pediatric Nephrology, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
Department of Pediatric Nephrology, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Eur J Pediatr. 2022 Jan;181(1):117-123. doi: 10.1007/s00431-021-04191-z. Epub 2021 Jul 3.
The study aims to present the incidence of COVID-19 in pediatric patients undergoing renal replacement therapy (RRT) and to compare the severity and outcomes of the disease between the dialysis and kidney transplant (KTx) groups. This multicenter observational study was conducted between 1 April and 31 December 2020 in Istanbul. Members of the Istanbul branch of the Turkish Pediatric Nephrology Association were asked to report all confirmed cases of COVID-19 who were on RRT, as well as the number of prevalent RRT patients under the age of 20. A total of 46 confirmed cases of COVID-19 were reported from 12 centers, of which 17 were dialysis patients, and 29 were KTx recipients. Thus, the incidence rate of COVID-19 was 9.3% among dialysis patients and 9.2% among KTx recipients over a 9-month period in Istanbul. Twelve KTx recipients and three dialysis patients were asymptomatic (p = 0.12). Most of the symptomatic patients in both the dialysis and KTx groups had a mild respiratory illness. Only two patients, one in each group, experienced a severe disease course, and only one hemodialysis patient had a critical illness that required mechanical ventilation. In the entire cohort, one hemodialysis patient with multiple comorbidities died.Conclusion: While most cases are asymptomatic or have a mild disease course, pediatric patients undergoing dialysis and a kidney transplant are at increased risk for COVID-19. What is Known: • In adult population, both dialysis patients and kidney transplant recipients are at increased risk for severe illness of COVID-19 and have higher mortality rate. • Children with kidney transplantation are not at increased risk for COVID-19 and most have mild disease course. • Data on children on dialysis are scarce. What is New: • Pediatric patients undergoing dialysis and kidney transplantation have an increased risk for COVID-19. • Most patients undergoing renal replacement therapy either on dialysis or transplanted develop asymptomatic or mild COVID-19 disease with a favorable outcome.
这项研究旨在报告在接受肾脏替代治疗（RRT）的儿科患者中 COVID-19 的发病率，并比较透析和肾移植（KTx）组之间疾病的严重程度和结局。这项多中心观察性研究于 2020 年 4 月 1 日至 12 月 31 日在伊斯坦布尔进行。土耳其儿科学会肾脏分会伊斯坦布尔分会的成员被要求报告所有接受 RRT 的确诊 COVID-19 病例，以及 20 岁以下接受 RRT 的患者人数。共有 12 个中心报告了 46 例确诊 COVID-19 病例，其中 17 例为透析患者，29 例为 KTx 受者。因此，在伊斯坦布尔，9 个月期间 COVID-19 在透析患者中的发病率为 9.3%，在 KTx 受者中的发病率为 9.2%。12 例 KTx 受者和 3 例透析患者无症状（p=0.12）。在透析和 KTx 组中，大多数有症状的患者都患有轻度呼吸道疾病。只有 2 名患者，每组 1 名，出现严重疾病，只有 1 名血液透析患者患有需要机械通气的危重症。在整个队列中，1 名患有多种合并症的血液透析患者死亡。结论：尽管大多数病例无症状或疾病轻微，但接受透析和肾移植的儿科患者患 COVID-19 的风险增加。已知：• 在成人中，透析患者和肾移植受者患 COVID-19 严重疾病的风险增加，死亡率较高。• 肾移植的儿童患 COVID-19 的风险不增加，大多数患者疾病轻微。• 关于接受透析的儿童的数据稀缺。新发现：• 接受透析和肾移植的儿科患者患 COVID-19 的风险增加。• 接受透析或移植的肾脏替代治疗患者中，大多数出现无症状或轻度 COVID-19 疾病，结局良好。
